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Urgent-start peritoneal dialysis results in fewer procedures than hemodialysis.
- Source :
- Clinical Kidney Journal; Apr2020, Vol. 13 Issue 2, p166-171, 6p
- Publication Year :
- 2020
-
Abstract
- Background Peritoneal dialysis (PD) is an underutilized modality for hospitalized patients with an urgent need to start renal replacement therapy in the USA. Most patients begin hemodialysis (HD) with a tunneled central venous catheter (CVC). Methods We examined the long-term burden of dialysis modality-related access procedures with urgent-start PD and urgent-start HD in a retrospective cohort of 73 adults. The number of access-related (mechanical and infection-related) procedures for each modality was compared in the first 30 days and cumulatively through the duration of follow-up. Results Fifty patients underwent CVC placement for HD and 23 patients underwent PD catheter placement for urgent-start dialysis. Patients were followed on average >1 year. The PD group was significantly younger, with less diabetes, with a higher pre-dialysis serum creatinine and more likely to have a planned dialysis access. The mean number of access-related procedures per patient in the two groups was not different at 30 days; however, when compared over the duration of follow-up, the number of access-related procedures was significantly higher in the HD group compared with the PD group (4.6 ± 3.9 versus 0.61 ± 0.84, P < 0.0001). This difference persisted when standardized to procedures per patient-month (0.37 ± 0.57 versus 0.081 ± 0.18, P = 0.019). Infection-related procedures were similar between groups. Findings were the same even after case-matching was performed for age and diabetes mellitus with 18 patients in each group. Conclusions Urgent-start PD results in fewer invasive access procedures compared with urgent-start HD long term, and should be considered for urgent-start dialysis. [ABSTRACT FROM AUTHOR]
- Subjects :
- PERITONEAL dialysis
CENTRAL venous catheters
CATHETERIZATION
HOSPITAL patients
Subjects
Details
- Language :
- English
- ISSN :
- 20488505
- Volume :
- 13
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Clinical Kidney Journal
- Publication Type :
- Academic Journal
- Accession number :
- 142835279
- Full Text :
- https://doi.org/10.1093/ckj/sfz053